2019 RN Mental Health NGN Online Practice B with Answers (60 Solved Questions)

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RN Mental Health Online Practice 2019 B with NGN w/ Rationales1.A nurse is caring for a client who is in an abusive relationship and is assisting in thedevelopment of a safety plan. Which of the following actions is the first component of a safetyplan?a.Identify signs of escalation of violencei.It is important for the client to be able to identify signs of escalation of violence,which are the greatest risk to the client. Therefore, this is the first component ofthe safety plan because it increases awareness of when danger is imminent andit is time to leave.2.A nurse is caring for a child who has conduct disorder and is behaving in a destructive manner,throwing objects, and kicking others. Which of the following therapeutic nursing interventionsis the priority?a.Reduce environmental stimuli.i.The greatest risk to the child and others is harm. Therefore, the nurse's priorityintervention is to reduce environmental stimuli in an attempt to de-escalate thebehavior and prevent injury.3.A nurse is updating the POC for a client who has bulimia nervosa and is 5% above their idealbody weight. Which of the following interventions should the nurse include in the plan?a.Identify the client's trigger foods.i.The nurse should identify the trigger foods that initiate the client's binge andassist the client to understand their thoughts and behavior that relate to thefood.4.A nurse is assisting a client who has a terminal illness adjust to progressive loss ofindependence. Which of the following statements made by the client indicates acceptance ofher illness?a."I am going to order a wheelchair for when I'm unable to walk."i.The client is recognizing the reality of continued loss of independence and isanticipating the need for assistive devices, which indicates the behavioralresponse of acceptance.5.A nurse is reviewing the medication administration for a client who is experiencing adverseeffects of chlorpromazine. The nurse should administer benztropine to relieve which of thefollowing adverse effects?a.Acute dystoniai.The nurse should administer benztropine, an anticholinergic agent, to relieveacute dystonia, which is an extrapyramidal adverse effect of chlorpromazine6.A nurse is caring for an older adult client who is experiencing delirium. Which of the followinginterventions should the nurse include in the client's plan of care?a.Permit the client to perform daily rituals to decrease anxiety.i.The nurse should provide a client who has delirium with a plan of care thatdecreases agitation and anxiety by permitting the client to perform daily rituals7.A nurse is receiving change-of-shift report for four clients. Which of the following clientsshould the nurse plan to see first?a.A client who is taking clozapine and reports sore throat and chills.i.When using the urgent vs. nonurgent approach to client care, the nurse shoulddetermine to first see the client who is taking clozapine and reports a sorethroat and chills. Clozapine can cause agranulocytosis, a serious adverse effectthat causes neutropenia. The nurse should withhold the medication and notifythe provider of these findings

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RN Mental Health Online Practice 2019 B with NGN w/ Rationales8.A nurse is planning care for a client who has made repeated physical threats toward others onthe unit. Although the client does not want to leave the unit, the nurse requests the providerto transfer the client to another unit, the nurse request the provider to transfer the client to aunit that is equipped to manage violent behavior. Which of the following ethical principlesshould the nurse apply in the situation?a.Nonmaleficencei.It is the responsibility of the nurse to do no harm to clients. The nurse isapplying the ethical principle of nonmalecence by requesting to transfer thisclient to a unit better able to manage their behavior and thereby prevent injuryto others on the unit.9.A nurse is performing a cognitive assessment to distinguish delirium from dementia in a clientwhose family reports episodes of confusion. Which of the following assessment findingssupports the nurse's suspicion of delirium?a.Easily distracted.i.Extreme distractibility is a hallmark manifestation of delirium.10.A nurse is creating a plan of care for a client who has been placed in seclusion afterthreatening to harm others on the unit. Which of the following interventions should the nurseinclude in the plan?a.Renew the prescription for the client every 4 hr.i.The nurse should assess the client's behavior frequently during seclusion andshould renew the prescription for seclusion for an adult client every 4 hr, for amaximum of 24 hr.11.A client who has a recent diagnosis of bipolar disorder is placed in a room with a client whohas severe depression. The client who has depression reports to the nurse, "My roommatenever sleeps and keeps me up, too." Which of the following actions should the nurse take?a.Move the client who has bipolar disorder to a private room.i.Clients who have bipolar disorder can disrupt the therapeutic milieu for otherclients. Therefore, the nurse should move this client to a private room12.A nurse is teaching the partner of a client who has bipolar disorder how to identifymanifestations of acute mania. Which of the following findings should the client' partnerreport to the provider?a.Inability to sleepi.During acute mania, the client is extremely active and does not sleep, which canlead to exhaustion. Therefore, the nurse should instruct the partner to reportthis finding.13.A nurse is teaching coping strategies to a client who is experiencing depression related topartner violence. Which of the following statements by the client indicates an understandingof the teaching?a."I will talk about my feelings with a close friend."i.Discussing feelings, such as fear and depression, with a support person is aneffective coping strategy and can provide the client with emotional support andother resources

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RN Mental Health Online Practice 2019 B with NGN w/ Rationales14.A nurse is discussing a 12-step program with a client who has alcohol use disorder and is in anacute care facility undergoing detoxification. Which of the following information should thenurse include in the teaching?a.The client should obtain a sponsor before discharge for an increased chance of recovery.i.The nurse should teach the client that peer support has been shown to increaseprogram attendance and the chances of recovery. If the client does not have asponsor, they can be assigned one when they begin attending the program.15.A nurse is assessing a client for risk factors for the development of depression. The nurseshould identify that which of the following factors places the client at an increased risk fordepression?a.The client has COPD.i.The nurse should identify that client who have a chronic medical illness are at anincreased risk for the development of depression.16.A nurse on a medical-surgical unit is assessing a client who sustained injuries 12 hr agofollowing a MVC. The client's admission blood alcohol level was 325 mg/dL. Which of thefollowing findings should indicate to the nurse that the client is experiencing alcoholwithdrawal?a.Blood pressure 154/96 mm Hgi.Physical manifestations of alcohol withdrawal occur in addition to psychologicaleffects. A client who is experiencing alcohol withdrawal is expected to havehypertension, tachycardia, and fever greater than 38.3° C (101° F). It will beimportant for the nurse to rule out infection in the client who has a fever.17.A nurse on a mental health unit observes a client who has acute mania hit another client.Which of the following action should the nurse take first?a.Call a team of staff members to help with the situation.i.The greatest risk is injury to the client and others. Therefore, the first action thenurse should take is to call for assistance to prevent further injury to themselvesor others.18.A nurse is planning discharge teaching for a client who has severe schizoaffective disorder.The nurse should identify that which of the following treatment options can offerinterdisciplinary services for the client at home?a.Assertive community treatmenti.Assertive community treatment provides comprehensive, community-basedservices to clients who have severe mental illness based upon individualizedneeds. Services are available in any setting, including the client's home, 24 hrper day and provide crisis intervention, medication services, and advocacy.19.A nurse is planning care for a client who has generalized anxiety disorder. At which of thefollowing levels of anxiety should the nurse plan to teach the client relaxation techniques?a.Mildi.The nurse should plan to teach the client relaxation techniques during the mildlevel of anxiety. This is when the client will be able to concentrate and processinformation.20.A nurse is education the parent of a child who has a new diagnosis of autism spectrumdisorder. Which of the following manifestations of this disorder should the nurse include inthe teaching?a.Language delayi.The nurse should identify that language delays are a manifestation of autismspectrum disorder

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RN Mental Health Online Practice 2019 B with NGN w/ Rationales21.A nurse in a mental health facility is caring for a client who has schizophrenia. Which of thefollowing findings places the client at the greatest risk for self-directed injury or injuringothers?a.Command hallucinationsi.A client who has schizophrenia and is experiencing command hallucinations canhear voices telling them to hurt themselves or others. Therefore, a client who isexperiencing command hallucinations is at the greatest risk for self-directedinjury or injuring others.22.A nurse on a mental health unit is caring for a group of clients. Which of the following actionsby the nurse is an example of the ethical principle of justice?a.Spending adequate time with a client who is verbally abusivei.By spending adequate time with a client who is verbally abusive, the nurse isdemonstrating the ethical principle of justice. When the nurse spends anappropriate amount of time with each client regardless of their behavior and inkeeping with their individual needs, the nurse guarantees that all clients receiveequal care.23.A nurse is providing teaching to the partner of a client who is in a rehabilitation program foralcohol use disorder. The nurse should identify that which of the following statements by theclient's partner indicates an understanding of the teaching?a."I will not take charge of my partner's work responsibilities."i.The nurse should identify that it is important for the individual who has thesubstance use disorder to take charge of personal responsibilities.24.A nurse is talking with a group of parents who have recently experienced the death of a child.Which of the following actions should the nurse take?a.Suggest forming a weekly support group for parents who have experienced the death ofa child.i.Support groups are a positive resource in the process of recovery for parentsfollowing the death of a child.25.A nurse is planning prevention strategies for partner violence in the community. Which of thefollowing strategies should the nurse include as a method of secondary prevention?a.Establish screening programs to identify at-risk clients.i.This is an example of secondary prevention. By establishing screening programs,the nurse can identify individuals who are at risk for partner violence in thecommunity and can take the necessary steps to address individual client needs26.A nurse is preparing to administer diazepam 7.5 mg IV bolus to a client for alcohol withdrawal.Available is diazepam injection 5 mg/mL. How many mL should the nurse administer?a.x mL= 1.527.A nurse is assessing a client who has bulimia nervosa. The nurse should expect which of thefollowing findings?a.Tooth erosioni.A client who has bulimia nervosa is likely to have dental caries and tooth erosioncaused by frequent exposure to gastric acid from vomiting.28.A nurse on an acute mental health facility is receiving change-of-shift report for four clients.Which of the following client should the nurse assess first?a.A client who is experiencing delusions of persecutioni.The presence of delusions of persecution indicates that this client is at thegreatest risk for injury due to the client's belief that a person in power is out toharm them. Therefore, the nurse should assess this client first.

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RN Mental Health Online Practice 2019 B with NGN w/ Rationales29.A charge nurse on a mental health unit is discussing client rights with a newly licensed nurse.Which of the following statements should the charge nurse make?a."Clients who are admitted involuntarily maintain the right to give informed consent forprocedures."i.Clients who are admitted involuntarily maintain the right to give informedconsent for treatment. They also have the right to give informed consent forprocedures.30.A nurse is assessing a client who has major depressive disorder and has been receivingamitriptyline for 1 week. Which of the following outcomes should the nurse expect?a.Greater risk of attempting suicide as affect and energy improvei.The nurse should identify that an initial response to amitriptyline can develop in1 week. For a client who has major depressive disorder with suicidal ideation,the energy to carry out a plan is increased after 1 week of treatment.31.A nurse in a mental health clinic is planning for four clients. Which of the following tasksshould the nurse delegate to an assistive personnel (AP)?a.Stay with a client who has anorexia nervosa for 1 hr after mealtimes.i.Staying with a client who has anorexia nervosa following mealtimes is within therange of function of an AP. APs are allowed to attend to the safety of clientswho are stable, and this task does not require assessment or technical skill.32.A nurse is preparing to discharge to home an older adult client who attempted suicide. Theclient lives alone and has difficulty performing ADLs. Which of the following referrals shouldthe nurse initiate? (SATA)a.Occupational therapy is correct.An occupational therapist can assist the client toperform ADLs.b.Meal delivery services is correct.Meal delivery services are necessary due to theclient's difficulty performing ADLs.c.Physical therapy is correct.A physical therapist can assess the client's mobility needsand assist with ADLs.d.Home health services is correct.Home health services provide a nursing assessment ofthe client's physical and mental status, as well as assistance with ADLs.33.A nurse is assessing a family's dynamics during a counseling session. The nurse shouldrecognize which of the following findings as an indication of a boundary issue?a.Older children who are responsible for their younger siblingsi.This is an example of enmeshed boundaries in which there are no distinctionsbetween the roles of family members.34.A nurse in a community health center is working with a group of clients who have post-traumatic stress disorder. Which of the following interventions should the nurse include toreduce anxiety among the group members?a.Guided imageryi.Guided imagery involves assisting the client to imagine a restful and safe place.This method is effective in reducing anxiety in clients who have post-traumaticstress disorder.

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RN Mental Health Online Practice 2019 B with NGN w/ Rationales35.A nurse is teaching the guardians of a client about their adolescent child's diagnosis of bulimianervosa. Which of the following statements made by the guardians indicates anunderstanding of their client's illness?a."It is important for our child to have regular dental checkups."i.For a client who has bulimia nervosa, repeated vomiting erodes tooth enameland predisposes the teeth to caries. Thus, the nurse should teach the guardiansthat regular dental checkups are important for a client who has bulimia nervosa36.A nurse is caring for a client who gave birth to a stillborn baby. Which of the followingstatements should the nurse make?a."I'll stay with you just in case you want to talk."i.This response demonstrates the therapeutic communication techniques ofoffering self and indicates the nurse's interest in the client and a desire tounderstand the client's feelings.37.A nurse is reviewing laboratory results for a client who has schizophrenia and is takingclozapine. Which of the following values should the nurse identify as a contraindication forreceiving clozapine?a.WBC count 2,500/mm^3i.Clozapine can cause agranulocytosis, which can be fatal due to overwhelminginfection. The nurse should identify a WBC count of less than 3,000/mm^3 as apossible manifestation of agranulocytosis and should withhold the medicationand notify the provider.38.A nurse in the emergency department is caring for four clients. Which of the following clientsis the nurse required to report as a potential victim of abuse?a.An older adult client who is bedbound and has a stage IV pressure ulceri.A stage IV pressure ulcer on an older adult client who is bedbound can indicatephysical neglect and warrants mandatory reporting.39.A nurse is caring for a child who is taking methylphenidate. The nurse should monitor thechild for which of the following findings as an adverse effects of methylphenidate?a.Tachycardiai.The nurse should monitor the child for tachycardia, which is an adverse effect ofmethylphenidate.40.A nurse is caring for an older adult client who begins to cry and states, "I knew God wouldpunish men and I deserve this horrible sickness!" Which of the following responses should thenurse make?a."Let's talk about what is upsetting you."i.The nurse is acknowledging the client's concerns and is showing a desire tounderstand what the client is thinking and feeling.41.A nurse observes a client on a mental health unit pushing on the locked unit door. Which ofthe following statements should the nurse make?a."It appears as though you would like to open the door."i.This statement is an example of the therapeutic technique of makingobservations. This technique encourages the client to notice the behavior sothat they can describe thoughts and feelings related to that behavior.42.A nurse is caring for four clients in an emergency department. The nurse should identify thatwhich of the following clients can give informed consent?a.A 35-year-old client who has major depressive disorderi.A client who has major depressive disorder is capable of making health caredecisions unless the client is determined to be legally incompetent.

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RN Mental Health Online Practice 2019 B with NGN w/ Rationales43.A nurse is performing an admission assessment on a client and notices that the client appearswithdrawn and fearful. To establish a trusting nurse-client relationship, which of the followingactions should the nurse take first?a.Inform the client that this administration is confidentiali.According to evidence-based practice, the nurse should first inform the clientabout confidentiality during the orientation phase of the nurse-clientrelationship.44.A nurse is teaching a newly licensed nurse about nursing care plans for clients who havedepressive disorders. Which of the following statements by the newly licensed nurse indicatesan understanding of the teaching?a."I will update the plan of care as a client's manifestations of depression change."i.The nurse should update the plan of care as a client's status and needs change.45.A nurse is admitting a client who has major depressive disorder and a new prescription fortranylcypromine. Which of the following over-the-counter medications that the client reportstaking should alert the nurse to a potential adverse reactions?a.Phenylephrinei.Clients who are taking tranylcypromine, an MAOI antidepressant, should nottake phenylephrine and other over-the-counter medications for sinuscongestion, colds, or allergies due to their actions on the sympathetic nervoussystem, which can result in severe hypertension.**NEXT GEN QUESTIONS BELOW……

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RN Mental Health Online Practice 2019 B with NGN w/ RationalesNext Gen Question:A nurse at an inpatient mental health facility is caring for a client who recently experienced a traumatic event.Exhibit 1:Vital Signs0730:Temperature 36.6° C (97.8° F)Heart rate 74/minRespiratory rate 16/minBlood pressure 118/74 mm Hg1400:Temperature 36.9° C (98.4° F)Heart rate 86/minRespiratory rate 18/minBlood pressure 114/78 mm HgExhibit 2:Nurses' Notes0730 Admission:Client was a witness during a recent violent crime at their place of employment. Several of the client's coworkerswere killed. The client has been experiencing feelings of guilt and anger.1400:The client continues to express feelings of guilt and anger and states, "I cannot ever go back to work. It is toodangerous." The client also states, "I don't know why I was allowed to survive. It's too painful to talk to my friendsand family about what happened."1.The nurse is providing teaching to the client. Which of the following statements should the nurseinclude in the teaching? (Select all that apply.)a."You should seek help if you have thoughts of self-harm" is correct.The nurse should informthe client that they should seek help immediately if they experience thoughts of self-harm orsuicidal ideation.b."It is common for people who survived a traumatic event to experience feelings of anxiety" iscorrect.Clients who have experienced a traumatic event can demonstrate manifestations ofsevere anxiety and panic attacks, including impulsivity and regression.c."A support group might be helpful to you during this time" is correct.The nurse shouldencourage the client to participate in a support group, which can provide emotional support for aclient who has experienced a traumatic event.

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RN Mental Health Online Practice 2019 B with NGN w/ RationalesNext Gen Question:A nurse is assessing an older adult client who is postoperative following a right knee arthroplasty.History and PhysicalDay 1 0800:75-year-old client who has osteoarthritis of the knees. Reports increased pain to the right knee following theirdaily walk of 3 miles.History of type 2 diabetes mellitus, GERD, hyperlipidemia, and hypothyroidism.No known allergies.Nurses' NotesDay 3 0800:Client is postoperative day three from right knee arthroplasty. Currently with operative knee in the continuouspassive motion (CPM) machine but attempting to take knee out of device. States, "I've had enough of this mess.I'm going home." Client is disoriented to time and place, oriented to self. Refuses to answer simple questions,rambles incoherently when spoken to. Will not follow simple commands. Client's family is at bedside and reportsthe client began displaying behavior changes the prior evening. States that client was awake most of the night andwas restless when they did fall asleep, appeared to be having nightmares. Attempted to get out of bed withoutassistance during the early morning hours.Surgical dressing to right knee dry and intact. No sign of redness or edema around the dressing. Client refuses toanswer questions about surgical pain or respond to prompts using pain scales. According to client's family, clienthas not received pain medication since before physical therapy yesterday afternoon and has not reported pain.Requested client's family to please remain at the bedside and to call for any needs or if the client attempts to getout of bed without assistance.Placed call to provider to report findings. Awaiting call-back.Graphic RecordDay 3 0800:Heart rate 115/minRespiratory rate 20/minBlood pressure 90/48 mm HgTemperature 38.6° C (101.5° F)Oxygen saturation 96% on room airWeight 63.5 kg (140 lb)Intake and Output (I&O)I = 750 mLO = 2,500 mLProvider PrescriptionsDay 1:Enoxaparin 30 mg subcutaneously twice dailyLevothyroxine 75 mcg PO once dailyOmeprazole 20 mg PO once dailyPravastatin 40 mg PO once daily at bedtimeMorphine 2 to 4 mg intermittent IV bolus every 4 hr PRN painHydrocodone 5 mg PO every 6 hr PRN painAcetaminophen 325 mg PO every 6 hr PRN pain or temperature greater than 38.3° C (101° F)Diagnostic ResultsDay 3 0800:Capillary blood glucose 92 mg/dL (82 to 115 mg/dL)

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RN Mental Health Online Practice 2019 B with NGN w/ Rationales2.A nurse is assessing a client who is displaying manifestations of delirium. Which of the followinginformation from the client's medical record are risk factors for delirium? (Select all that apply.)a.Hospital environment is correct.Risk factors for delirium include a change in hospital rooms,such as moving from the ICU to a private room, client's age, vision or hearing impairments,recent surgical procedures, and infection. A change in room location can be disorienting to aclient and lead to delirium.b.Client's age is correct.Risk factors for delirium include a change in hospital rooms, such as fromthe ICU to a private room, client's age, vision and hearing impairments, recent surgicalprocedures, and infection. Older adult clients have a higher risk for developing delirium frombeing in unfamiliar surroundings, such as a hospital.c.Postoperative is correct.Risk factors for delirium include a change in hospital rooms, such asfrom the ICU to a private room, client's age, vision or hearing impairments, recent surgicalprocedures, and infection. Surgical procedures increase a client’s risk for delirium due to theeffects of anesthesia and pain medications, the risk for infection, and the potential for alteredvital signs and fluid and electrolyte balance.d.Fever is correct.Risk factors for delirium include a change in hospital rooms, such as from theICU to a private room, client's age, vision or hearing impairments, recent surgical procedures,and infection. Altered vital signs and the risk for infection, as evidenced by fever, increase aclient’s risk for developing delirium.

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